Glaucoma Treatment Options

Young woman smiling at sunset

What Is the First Line of Treatment?

Eye drops are the first line of treatment, and most patients respond well to these simple, safe medications.There are many options of eye drops currently available, and your doctor will help coordinate your care to find effective, comfortable, and affordable medications. Some recent data show that laser treatment to the eye’s internal drain, the trabecular meshwork, can be used as first- line treatment. However, this procedure has a limited duration of effect and can only be performed twice per eye.


Most patients won’t require surgery, but there are many surgical options for glaucoma. Some procedures are minimally invasive and carry a very low risk of complications. A general rule of thumb is that the more effective the procedure is at lowering eye pressure, the greater the risk.
Here are some of the surgical options:

Happy Doctor

Surgical Options

Laser Trabeculoplasty

Trabeculoplasty is a laser surgery performed in the office or at an outpatient center. This is a treatment for open-angle glaucoma (the most common form) in which the doctor uses a small laser to open up your clogged channels and improve the flow of fluid from the eye. It can take a few weeks to have a noticeable effect. Generally, this kind of surgery has to be repeated every one to five years and can be performed twice. Patients may or may not still need medication after the surgery. 


Treatment for angle-closure glaucoma in which your doctor uses a laser to make a tiny hole in the iris. In many cases, this is the first line of attack for angle-closure, which is much more serious.

Minimally Invasive Glaucoma Surgery

This procedure involves the implantation of small drainage devices at the time of cataract surgery. The risk is very low with this procedure, the effect variable, but helps the vast majority of the time.

Medication Implants

Concentrated medications can be implanted in the eye at the office. Over time the medication dissolves. This step is usually no more effective than eye drops, and is utilized for patients that have difficulty with using eye drops and need a temporary treatment.


This is a more complicated surgery done in an operating room. The surgeon will make a small hole in the sclera – that is the wall of the eye – with a trapdoor over it, to allow some aqueous humor to drain into a bubble, called a filtration bleb. This is hidden under the upper eyelid. The fluid will be reabsorbed by the body. Trabeculectomy is recommended for advanced patients who may no longer be responding to other treatments.

Glaucoma Drainage Devices

Other patients with severe glaucoma may need a drainage tube implanted in their eye, which will divert fluid to a reservoir under the eyelid, from which it can be reabsorbed by the body. This is sometimes called an aqueous shunt. These devices are generally only needed by a small subset of patients, and.. are generally considered a last resort for patients who are not responding to other treatments.

If you are at high risk of glaucoma, you should talk to your eye doctor about screening options, which might include tonometry and gonioscopy. If you or a loved one has a glaucoma diagnosis, then make an appointment today to discuss your options.

When to See a Doctor

Don’t wait for noticeable eye problems before booking an appointment with a physician. Primary open-angle glaucoma gives few warning signs or symptoms until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough for successful preventive treatment.

At the minimum, the American Academy of Ophthalmology recommends a comprehensive eye exam for all adults starting at age 40 and every three to five years after that if one has no glaucoma risk factors. After age 60. yearly screenings are recommended. 

In addition, be aware that a severe headache or pain in your eye or eyebrow, nausea, blurred vision, or rainbow halos around lights may be the symptoms of an acute angle-closure glaucoma attack. With two or more of these symptoms one should seek immediate care at an emergency room or ophthalmologist’s office. away.

For more information on glaucoma in Atlanta, Georgia, please contact us today to set up a consultation!